Abstract

Renal cortical necrosis (RCN) is a rare cause of acute renal failure (ARF), accounting for 3% of all ARF cases in adults in developing countries, but up to 15% in pregnancy-related ARF (PR-ARF). It is caused by a significant reduction in renal perfusion due to vasospasm, microvascular injury, intravascular coagulation or a combination of these factors. Histology shows a diffuse or patchy necrosis of the renal cortex; the medulla and a thin rim of subcapsular cortex are usually spared. HELLP syndrome (haemolysis, elevated liver enzymes and low platelets) is a variant of severe pre-eclampsia which often complicates with renal failure, most of the time because of acute tubular necrosis (ATN) but occasionally because of RCN, through a thrombotic micro-angiopathic process. We report on a case of HELLP syndrome where the patient developed ARF as a result of RCN.